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Title: An account of the plague which raged at Moscow, in 1771

Author: Charles de Mertens

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Language: English

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AN

A C C O U N T

OF THE

PLAGUE

WHICH

RAGED AT MOSCOW,

IN

1771.

BY CHARLES DE MERTENS, M. D.

MEMBER OF THE MEDICAL COLLEGES OF VIENNA AND

STRASBURG, FORMERLY IMPERIAL AND ROYAL

CENSOR, AND CORRESPONDING MEMBER

OF THE MEDICAL SOCIETY

AT PARIS.

TRANSLATED FROM THE FRENCH, WITH NOTES.

LONDON:

PRINTED FOR F. AND C. RIVINGTON, NO. 62,

S T . PAUL’ S CHURCH-YARD.

1799.

PREFACE.

Histories of the Plague, exhibiting the modifications it undergoes in different climates, must at all times

and in all places be acceptable, if not to the public at large, at least to that class of persons who make the
art of medicine their study and employ: But, to a country situated like our own, histories of this terrible
disorder occurring in the northern parts of Europe are more particularly interesting, by holding up to our
view a picture of what it probably would be, whenever it should visit us again. Such a picture is presented
to us in the history of the plague which depopulated Moscow and other parts of the Russian empire, in the
year 1771, and which forms the subject of the following pages. What, at the present time, must give a
greater degree of interest to such a subject, is the danger to which we are exposed of importing the
pestilential contagion from America[1], on the one hand, and from Turkey and the Levant on the other: For,
although the cold has, happily, suppressed for the present the pestilence which has been committing such
dreadful ravages at Philadelphia and New York; yet is it to be feared that it may be retained in many
houses, and lie dormant in various goods, ready to break out again, whenever it shall be favoured by the
weather[2]: And no one who is acquainted with the nature of that contagion can deny the possibility of its
importation from America into this country, either now or hereafter, by infected persons or infected
merchandise. On the other hand, are we not threatened with a similar danger from the East? In executing
the hostile operations which are going forwards in the Mediterranean, it seems scarcely possible for our
fleets and armies to keep clear of contagion. No nation was ever long engaged in a war with the Turks,

[i]

[iii]

[iv]

[v]

without taking the plague. In this respect they are as much to be dreaded by their friends as their foes. If, in
the present contest, Italy, and France, and England shall escape this scourge, it will form an exception to
past events, which all Europe must devoutly pray for.

Under these circumstances the Translator thought it would be useful to call the attention of the

practitioners in medicine of this country, to the subject of pestilential contagion, by publishing the following
Account of the Plague at Moscow in the year 1771. Besides the narrative of the rise and progress of the
disorder, and the description of its symptoms and treatment, this account contains also a detail of the
methods which were successfully employed in that city for checking and totally extinguishing the contagion;
and in particular a detail of the means by which a large edifice, situated in the centre of Moscow, and
containing about one thousand four hundred persons, was preserved from the pestilence during the whole
of the time that it raged there.

This account is translated from a treatise republished in French, and originally written in Latin by Dr.

Mertens, under the following title: “Traité de la Peste, contenant l’Histoire de celle qui a régné à
Moscou en 1771; par Charles de Mertens, Docteur en Medecine, &c. ouvrage publié d’abord en
Latin[3]; actuellement mis en François, &c. à Vienne, 1784.” The author (who was physician to the
Foundling-Hospital, at Moscow, and resided in that city during the whole of the time that the plague raged
there) divides his treatise into four chapters; in the first of which he gives a history of the plague as it
appeared at Moscow; in the second, he treats of the diagnosis; in the third, of the curative treatment; and
in the fourth, of the precautions or methods of prevention.

So many works have been published on the plague, that whoever writes a regular treatise on this

disorder cannot avoid repeating many observations that have been made by others before him. Hence,
instead of dividing the present pamphlet into chapters and sections, and following the original word for
word throughout; the translator has taken the liberty of extracting from the two last chapters those parts
only which contain new observations, or which have an immediate reference to the narrative; which last he
has translated entire, excepting half a dozen lines at the beginning, that seem to have been introduced by
the author for no other purpose but that of quoting professor Schreiber’s[4] work on the plague, which
broke out in the Ukraine in the years 1738 and 1739.

Besides the preface[5], and some other matters noticed in their respective places, the following topics

of discussion have been omitted; viz.

1st. the comparison between the plague and the smallpox;
2d. the reflexions on the inoculation of the plague;
3d. the precautions to be employed in wars with the Turks; and
4th. the precautions continually necessary in places exposed to the pestilential contagion.
These topics have been omitted, because with regard to the first, as the smallpox and the plague agree

in no other respect but in that of being propagated by contagion, a comparison between them seems to be
quite unnecessary; because, as to the second, the inoculation of the plague is proved to be useless by the
well-established fact, that the same person is susceptible of taking it several times[6]; and because with
regard to the third and fourth points, they only lead to repetitions of general and particular precautions
mentioned in other parts of the pamphlet, or suggest hints which do not apply to an insular situation like
ours.

Next to a detail of all the events which took place during the raging of the plague at Moscow, the

translator has especially aimed at a full and accurate delineation of the symptoms. In doing this, he has
taken the pains to compare the description given by Dr. Mertens, with those of two other writers on the
same subject; viz. Orræus and Samoïlowitz. Thus he flatters himself that all the different types and
modifications which the plague assumes in the Northern parts of Europe, are here developed in such a
manner, as to enable those who have never seen the disorder, to detect it on its first appearance, or in its
early progress, should this country have the misfortune to be visited by it again.

January 2, 1799.

AN

ACCOUNT

OF THE

PLAGUE AT MOSCOW.

In 1769 war broke out between the Russians and Turks. The year following intelligence was received

[vi]

[vii]

[viii]

[ix]

[x]

[1]

that the Turks had carried the plague into Wallachia and Moldavia, where it was making great ravages;
and that in the town of Jassy a number of Russians had been carried off by a disorder, which, on its first
appearance, was called by some of the faculty, a malignant fever; but which the most eminent physicians in
the place declared to be the plague. Baron Asch, first physician to the army, sent an account of this
disorder in a letter, written in German, to his brother, a physician at Moscow, who showed it to me. The
following is a translation thereof: “It attacks people in different ways. Some are slightly indisposed,
complaining for several days of a headach, sometimes very violent, at other times less so, and now and
then ceasing altogether, and then coming on again. The patients are affected with pains in the chest, and
particularly in the neck; they gradually become languid and dejected, with something like intoxication and
drowsiness. They have a particular taste in their mouths, which soon turns to a bitter; at the same time they
have an ardor urinæ. To these succeed chilly and hot fits, and, lastly, all the symptoms which characterize
the plague. The disease sometimes terminates favourably by perspiration, before the appearance of
exanthemata, buboes, or carbuncles. The contagion is sometimes more rapid and more violent in its action;
in that case the infected are suddenly seized after making a hearty meal, after a fit of anger, or too much
bodily motion, with head-ach, nausea, and vomiting; the eyes become inflamed and watery (larmoyans),
and pains are felt in those parts of the body where buboes and carbuncles are about to appear. There is no
great degree of heat. The pulse is sometimes full and hard; sometimes small, soft, and scarcely perceptible;
it often intermits, and, what should be particularly noticed, it is often feeble. These symptoms are
accompanied with lassitude, a white tongue, dry skin, urine of a pale yellow colour, or turbid, but without
sediment; frequently with a diarrhœa, which it is difficult to stop; and, lastly, with delirium, buboes,
carbuncles, and petechiæ[7].”

The following summer this disorder spread into Poland, and committed great havoc there; from thence

it passed to Kiow, where it destroyed four thousand souls. Immediately on its appearance at the last-
mentioned place, all communication between that town and Moscow was cut off; guards were stationed
on all the great roads, and all travellers were ordered to perform quarantine for several weeks.

At the end of November 1770, the anatomical dissector, at the military-hospital in Moscow, is

attacked with a putrid petechial fever, which carries him off in three days. The attendants upon the sick[8]
of this hospital dwelt with their families in two rooms separate from the wards. In one of these rooms they
fall ill one after the other, till, at length, all of them, to the number of eleven, are seized with a putrid fever,
accompanied with petechiæ; buboes and carbuncles appear in some of them; and most of them die
between the third and fifth day. The attendants occupying the other room are seized in like manner with the
same disorder.

On the 22nd of December, we are required to meet at the Board of Health. The first physician to the

military-hospital states the circumstances, which I have just related, the truth of which is confirmed by the
evidence of three other physicians, who farther report, that fifteen among the attendants, including their
wives and children, had fallen victims to this disorder since the end of November; that five still continued ill
of it; but that it had not yet shown itself in any of the hospital-wards. Eleven physicians were present at this
consultation, and we all agreed that the disorder under consideration was the plague, except Dr. Rinder,
state-physician[9], who had visited the sick, several times, in company with Mr. Schafonsky, and who
pronounced it to be merely a putrid fever; an opinion which he maintained both in conversation and by
writing.

This hospital stands out of the town, near the suburb inhabited by the Germans, from which it is

separated by a small stream, called the Yausa. We advised that it should be immediately shut up, and that
guards should be placed round it, in order to cut off all communication; that all the attendants upon the
hospital-invalids should be removed, together with their wives and children, to a detached situation, care
being taken to separate the infected from the healthy; and, lastly, that all the clothes and furniture, not only
of those who were dead, but likewise of those who still survived, should be burnt.

The cold had set in later this year than usual; the weather was very damp and rainy until the end of

December, when a hard frost came on, and continued through the remainder of the winter.

In addition to our joint report, Field-Marshal Count Soltikoff, governour-general of the place,

consulted me in private, and desired to know what steps I thought adviseable under the present
circumstances. On a subject pregnant with so much danger to the public at large, I did not hesitate to
communicate my sentiments in the most unreserved manner. Accordingly I put into the governor’s hands a
paper, wherein I laid great stress upon the necessity of employing every possible precaution with regard to
the hospital, where I affirmed, that the plague had appeared among the attendants, as before mentioned; I
added, that it would be necessary to make strict enquiries to ascertain, whether the contagion was
concealed in any part of the town, and that, wherever it should be discovered, the same precautions, as in
the case of the hospital, should be adopted: that, for the same purpose, it would be further necessary to
desire the physicians and surgeons, whenever they should perceive any unusual or doubtful symptoms in
their patients, to give immediate notice thereof to the Board of Health; and to order the police-officers to
appoint a consultation of physicians, whenever several persons should fall ill in the same house. I
remarked, however, that there would be great difficulties in the business, if the contagion existed in other

[2]

[3]

[4]

[5]

[6]

[7]

[8]

parts of the town besides the hospital; but, I added, that, even in this case, we might hope to eradicate the
evil when the frost should set in, provided speedy and proper measures were resorted to.

We wished that what had passed on this subject should not transpire; but the rumour of the plague

having broke out at Kiow, some months before, had produced such an effect upon the minds of the public,
that the precautions which were adopted, with regard to the military-hospital, threw the whole city into the
greatest alarm. All attempts to dissipate the fears of the inhabitants were fruitless.

After some days, however, when it was known that only seven persons in the hospital itself were ill of

the disorder, and that the rest remained free from infection, the public fell into the opposite extreme, and
thinking themselves in perfect security, the grandees, nobles, merchants, common people, in a word, all the
inhabitants, except the governour and a few others, ceased to give themselves any further trouble about the
means of prevention.

This idea of security, which was countenanced by the before-mentioned state-physician, Dr. Rinder,

continued until the month of March. The medical consultations ceased. In spite of all our efforts to the
contrary, every kind of precaution was neglected in the city; it was only at the military-hospital that, by
order of the Empress, the means of prevention were still observed; in consequence whereof the plague
was entirely suppressed there, after twenty-four persons had been seized with it, only two of whom
recovered[10]. Six weeks after the death of the last of them, all their clothes, beds, &c. together with the
house, to which they had been removed, and which was built of wood, were burnt. The hospital was
opened again at the end of February.

The generality of mankind judge of things by events only; and will never believe that the plague is

among them, until they have certain proof thereof in the number of funerals[11]. It is owing to this and other
mistaken notions, that the plague is not put a stop to in the beginning; at which period it may be compared
to a spark which might easily be extinguished, but which, if left to itself, bursts out into a conflagration
which nothing can resist.

The opinion which went to assure the inhabitants that they were safe from the plague, was very

generally believed, as in such cases almost always happens[12]. It only remained for us to console
ourselves with the consciousness of having discharged our duty faithfully, and to the best of our abilities.
Would to God that the business had stopped here, and that what afterwards took place had not confirmed
the truth of our assertions. We should not then have beheld the dreadful destruction of so many of our
fellow-creatures, nor have witnessed the most horrid of all public calamities.

On the 11th of March we are again convened at the Board of Health. In the centre of the town there

was a large building used for manufacturing clothing for the army; three thousand persons were employed
in it, nearly a third part of whom, of the most necessitous class, occupied the ground-floors; the rest, after
working there the whole day, returned in the evening to their respective homes, in different parts of the
town. Dr. Yagelsky, at that time second physician to the Military Hospital, whom the Governor-General
had sent to the manufactory in the morning, brings word that he had found several patients, (eight to the
best of my recollection) labouring under the same disorder, (accompanied with petechiæ, vibices,
carbuncles, and buboes) which he had seen three months before at the military hospital; and that on seven
dead bodies which he had examined, he had perceived similar appearances. On enquiring of the workmen
in the manufactory, in what manner, and how long this disorder had made its appearance among them, he
was told that a woman who had a swelling in her cheek, had betaken herself to one of her relations who
lived in the manufactory, and had died there; and that, from that time, one or other of them was every day
taken ill of the disorder. They further stated, that from the period above-mentioned to the present day, they
had lost one hundred and seventeen persons, including the seven dead bodies not yet interred. This
account given by Dr. Yagelsky, was corroborated by two other physicians, who had been sent the same
day to examine the patients and dead bodies.

In a Memoir addressed to the Governor-General and the Senate (by whom we had been called

together) we renew our declarations, that this disorder is the plague[13]; and we advise them to remove out
of the town all the persons dwelling in the manufactory, taking care to separate the sick from the healthy;
that they should order the clothes and furniture of the dead and infected to be burnt; and that the strictest
search should be made to find out whether the contagion existed in any other part of the city. The
inhabitants are again seized with a panic; and they now too well perceive the consequences of their neglect
of the precautions recommended. We were thirteen physicians at this meeting[14], two of whom, who three
months before had agreed with us that the disease which broke out at the military hospital was the plague,
now said that the present disorder was not the plague, but a putrid fever; an opinion which they enforced in
a separate conference with the Senate. These two physicians (Drs. Kuhlmann and Schiadan) who still
differed from us in opinion, had been led into their error, by observing that the number of deaths in the
town was not greater than usual, but rather less than in the preceding years, and that there were very few
people ill.

Some days after, being summoned to meet the other physicians and surgeons at the senate, where

each of us was required to deliver our sentiments explicitly, I affirmed, in the most solemn manner, that I

[8]

[9]

[10]

[11]

[12]

[13]

[14]

was thoroughly convinced that the disease under consideration was the plague; ten of my colleagues were
of the same opinion, and the two others before mentioned still maintained the contrary[15]; nevertheless,
they admitted the propriety of adopting precautions against a disorder, which, though not the plague, was
of a contagious nature.

The first day (the 11th of March) is spent in deliberations. The infected building is shut up, and guards

are placed there, to prevent any person from going in or coming out. Several make their escape through
the windows, and the rest are removed out of the town during the night, the uninfected to the convent of
St. Simon, and the infected to the convent of St. Nicholas, one of which is distant six, and the other eight
versts[16]; from Moscow. These convents are surrounded with high walls, and have only one entrance. As
it was discovered that some had died among the workmen who lived in their own houses, these were
taken to a third convent, situated in like manner out of the town. Orders were given to the surgeons who
had the care of all these people, to transmit daily to the Board of Health a list of the sick and dead. A
committee of physicians was appointed to regulate every thing concerning the treatment of the sick, and the
keeping of those who were performing quarantine free from infection; and great attention was paid to the
interment of the dead. Drs. Erasmus and Yagelsky (now no more!) were entitled to great praise for the
manner in which they acquitted themselves in this business. When any one of those who were under
quarantine was taken ill, he was put in a separate room, and kept there until the symptoms of the plague
shewed themselves, when he was conveyed in a carriage, by persons hired for that purpose, to the pest-
house, viz. the convent of St. Nicholas.

The public baths, where the people are accustomed to go, at least once a week, were shut up. The

town was divided into seven districts, to each of which one physician and two surgeons were appointed,
for the purpose of examining all the sick as well as the dead bodies; in which business police-officers were
joined with them. It was forbidden to bury the dead within the city; proper places for burying-grounds
were fixed upon at some distance from the town. It was ordered, that whenever any one of the common
people should be seized with the plague, he should be sent to the hospital of St. Nicholas, and that, after
burning his clothes and furniture, those who had been living in the same apartment should be detained for
the space of forty days in some buildings appropriated to that purpose out of the town; that if the like
occurrence should happen in the house of a principal inhabitant or person of rank, all the servants who had
been in the same room with the patient should perform quarantine, and that the master, together with all his
family, should remain shut up in his own house for the space of eleven days. All this was sanctioned and
passed into the form of a law by a resolution of the Senate. General Peter Demitrewich de Yeropkin, not
more distinguished by his birth and valour than by his polished manners and humane disposition, was
appointed by the Empress, Director-General of Health.

Notwithstanding what had happened, the number of those who were convinced that the plague had

reached Moscow, was as yet inconsiderable. Dr. Orræus, physician to the army, who had visited
impested patients at Jassy, was now passing through Moscow in his way to Petersburgh, and was
requested to examine the sick and dead bodies before mentioned, which he accordingly did, and declared,
that the disorder was exactly like that which, a short time before, had proved so destructive in Moldavia
and Wallachia; that it was, in fact, the plague. This was further confirmed by Dr. Lærch, who was just
returned from Kiow, where he had remained during the time that the plague raged there.

The weather continued very cold until the middle of April, in consequence of which the contagion

became more fixed and inactive, attacking only those who dwelt with the infected. In the pest-house, the
daily number of deaths did not exceed three or four; and of the manufacturers who were performing
quarantine only about the same number fell ill.

According to the reports of the physicians, surgeons, and police-officers, the town appeared to be

healthy. Almost every body believed that the physicians who had called the disorder the plague, had
imposed upon the public; others entertained doubts on the subject. Things went on in this way until the
middle of June, during which time nearly two hundred persons had died at the hospital of St. Nicholas. The
number of sick and dead diminished daily there, in so much that, for a whole week, although the weather
was very warm, not one fell ill of the disorder, and there only remained in the hospital a few convalescents.
No further vestige of the disorder could be traced in the town.

As among the workmen of the manufactory, who had been removed from their own houses to a third

convent at a distance from the other two, in order to perform quarantine, not one had been attacked with
the disorder for the space of two months, they were allowed to return to their respective homes.

We now began to flatter ourselves that the plague had been entirely eradicated by the precautions

which had been adopted. Scarcely, however, had we indulged in these fond hopes, when, towards the end
of June, some people are taken ill of the same disorder at the hospital of St. Simon, where the quarantine
was performed. On the 2nd of July, six people die in one night at a house in the suburb of Preobraginsky;
a seventh, who lived with them, absconded[17]. Livid spots, buboes, and carbuncles are found upon the
dead bodies. On the following days, many of the common people fall sick in different quarters of the town,
and the mortality increases to such a pitch, that the number of deaths, which commonly amounted to about
ten or fifteen per day, and which, even during the prevalence of putrid fevers (as was the case for the two

[15]

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[17]

[18]

[19]

[20]

[21]

last years) did not exceed thirty, amounted at the end of July to as many as two hundred in the space of
twenty-four hours. The sick, as well as the dead bodies, exhibited large purple spots and vibices; in many
there were carbuncles and buboes. Some died suddenly, or in the space of twenty-four hours, before the
buboes and carbuncles had time to come out; but the greatest number died on the third or fourth day.

In the middle of August, the number of deaths amounted daily to four hundred; and at the end of the

same month to as many as six hundred. At this time buboes and carbuncles were more frequent than they
had been in July. At the beginning of September there were seven hundred deaths in the space of twenty-
four hours; in a few days, there were eight hundred deaths within the same number of hours; and a short
time after, the deaths amounted to one thousand in a day!

The havoc was still greater during the time of the riots, which began on the 15th of September, in the

evening; when an outrageous mob broke open the pest-houses and quarantine-hospitals, renewing all the
religious ceremonies which it is customary with them to perform at the bed-side of the sick[18], and digging
up the dead bodies and burying them afresh in the city. Agreeably to their ancient custom, the people
began again to embrace the dead, despising all manner of precaution, which they declared to be of no
avail, as the public calamity (I repeat their own words) was sent by God, to punish them for having
neglected their ancient forms of worship. They further insisted, that as it was pre-ordained who should and
who should not die, they must await their destiny; therefore, that all endeavours to avoid the contagion
were only a trouble to themselves, and an insult to the Divinity, whose wrath was only to be appeased by
their refusing all human assistance[19]. General Yeropkin, with a small party of soldiers drawn together as
speedily as possible, dispersed the mob, and restored tranquillity in a few days, after which every thing
was placed on its former footing. This vast concourse and intermixture of the healthy and infected, caused
the contagion to spread to such a degree, that at this time the daily number of deaths amounted to one
thousand two hundred and upwards!

Moscow, one of the largest cities in Europe, consists of four circles, or inclosures, one within another;

the smallest, which occupies the centre, is called Kremmel, and the second, which surrounds it, Kitaya, (or
Chinese-Town); they are both inclosed by brick-walls, and the houses within them are built of brick; the
third, which is called Bielogorod (or White-Town) is without walls, they having been levelled with the
ground; and, lastly, the fourth called Zemlanoïgorod (from Zemla, land or earth, and Gorod, town) is
defended by a ditch and rampart of earth[20]. In the two last-named parts of Moscow the houses are, for
the most part, constructed of wood. These houses do not stand close together, but are detached with
spaces between, and, in general, only one family inhabits each; hence they rarely consist of more than one
story, and often of a ground-floor only. The nobles keep a great number of servants; and the common
people live crouded together in small wooden houses[21].

In winter time the nobles repair to Moscow, from all parts of the empire, bringing with them a large

train of attendants. Great numbers of the common people, who were engaged during the summer in
agricultural labour, return to this great city in the winter, to gain subsistence by different employments. This
conflux of people makes the town so full, from the month of December to March, that the population, at
this season, amounts, according to some computations, to two hundred and fifty thousand; according to
others, to three hundred thousand. In the month of March, people begin to go into the country again;
hence, during the summer, the number of inhabitants is, at least, one-fourth less than in winter. In 1771 the
fear of catching the plague had caused a much greater number to leave the city; so that I do not think that,
in the month of August, there were more than one hundred and fifty thousand remaining in the place. An
idea may be formed of the destructive nature of this disorder, and the terrible activity of its poison, by
reflecting, that of these one hundred and fifty thousand inhabitants, twelve hundred were daily carried off
by it, (in the month of September!) The number of deaths kept at this rate for some days, and then
diminished to one thousand. As the populace, during the riots, had re-established all the religious
ceremonies customary on burying the dead, almost all their priests, deacons, and other ecclesiastics, fell
victims to the contagion.

The people, brought to a sense of their duty, partly by the rigorous measures employed against them,

and partly by seeing that the public calamity had been aggravated by their disorderly proceedings, now
began to implore our assistance. The monasteries and other pest-houses were full; the sick were no longer
carried thither; the contagion had spread every where; insomuch that the city itself might be considered as
one entire hospital. All, therefore, we could now do, was to exhort every individual to take care of himself;
to warn all those who were yet free from the contagion, to avoid, as much as possible, touching with their
bare hands any infected person; to direct them to burn the clothes, and every thing else that had been used
by those who had been ill of the plague; and, lastly, to keep their rooms clean and well aired.

At this time Count Gregory Orlow[22] arrived at Moscow, invested with full powers by the empress.

I received an order, in common with the other physicians, to deliver, in writing, my private sentiments on
the subject; we were required to turn our attention principally to the most proper measures for destroying
the contagion[23]. Having taken the necessary steps to prevent all further popular commotions, the Count
selected, from all our papers, what appeared of most moment, and drew up a set of regulations, as well for
the treatment of the sick, as for the keeping of those who were yet well, free from infection. He also

[22]

[23]

[24]

[25]

[26]

[27]

[28]

ordered new hospitals to be immediately built for the reception of the poor seized with the plague[24].

Some months had elapsed since the plague had been carried to many of the villages, as well in the

vicinity as at a distance from Moscow. Persons who fled from this city had also carried it with them to
Kalomna (Kaluga, according to Orræus), Yaroslaw, and Tula. Inspectors of health, attended by
physicians and surgeons, were sent to these infected towns and villages.

A Council of Health was formed, composed of General Yeropkin (who was president), of some

counsellors of state, and of three physicians, and one surgeon. This council received daily reports from the
physicians and police-officers, and took cognizance of every thing which related to the health of the
inhabitants. Two physicians, Drs. Pogaretzky and Meltzer, being offered a reward of one thousand
roubles, undertook, each of them, the care of a pest-hospital; and went thither accordingly.

On the 10th of October the frost set in; from that day the disorder was less fatal, and the contagion

became more fixed. The number of sick and dead gradually diminished; and the disorder, which a short
time before had terminated on the second or third day, now kept on to the fifth or sixth. Neither those
large purple spots, which we have before described, nor carbuncles, were by any means so frequent as
they had been; buboes were now almost the only tumours found upon the infected.

The hard frost[25] which prevailed during the two last months of the year, weakened the pestilential

virus to such a degree, that those who attended the sick and buried the dead were in much less danger of
being infected; and when they were infected, the symptoms were much milder; so that at this period,
several persons who had the plague were but slightly indisposed, and walked about though they had
buboes upon them.

At the close of the year 1771, this dreadful scourge ceased, by the blessing of God, at Moscow, and

in every other part of the Russian empire. Besides the three towns before-mentioned, upwards of four
hundred villages had been infected.

The weather was intensely cold during the whole of the winter. In order to destroy all remains of the

contagion, the doors and windows of the rooms in which there had been any persons ill of the plague,
were broken and the rooms were fumigated with the antipestilential powder[26]; the old wooden houses
were entirely demolished. The effects of the plague were traced in every part of the city. Even as late as
the month of February, 1772, upwards of four hundred dead bodies were discovered, which had been
secretly buried the year before in private houses. So powerful is cold in destroying the contagion, that not
one of those who were employed in digging up these bodies, and carrying them to the public burying-
grounds, became infected[27].

The total number of persons carried off by the plague amounted, according to the reports transmitted

to the Senate and Council of Health, to upwards of seventy thousand; more than twenty-two thousand of
this number of deaths happened in the month of September alone[28]. If we add to these, the private and
clandestine interments[29], the whole number of deaths in Moscow will amount to eighty thousand[30]: and
reckoning those who died in upwards of four hundred villages, and in the three towns of Tula, Yaroslaw
and Kalomna (or Kaluga)[31], it will follow that this plague swept off altogether as many as an hundred
thousand persons!

For carrying away and burying the dead, criminals capitally convicted or condemned to hard labour,

were at first employed; but afterwards, when these were not sufficient for the purpose, the poor were hired
to perform this service. Each was provided with a cloke, gloves, and a mask made of oiled cloth; and they
were cautioned never to touch a dead body with their bare hands. But they would not attend to these
precautions, believing it to be impossible to be hurt by merely touching the bodies or clothes of the dead,
and attributing the effects of the contagion to an inevitable destiny. We lost thousands of these people, who
seldom remained well beyond a week. I was informed by the Inspectors of Health, that most of them fell ill
about the fourth or fifth day.

The plague, as is generally the case, raged chiefly among the common people; the nobles and better

sort of inhabitants escaped the contagion, a few only excepted, who fell victims to their rashness and
negligence. The contagion was communicated solely by contact of the sick or infected goods; it was not
propagated by the atmosphere, which appeared in no respect vitiated during the whole of the time. When
we visited any of the sick we[32] went so near them that frequently there was not more than a foot’s
distance between them and us; and although we used no other precaution but that of not touching their
bodies, clothes, or beds, we escaped infection. When I looked at a patient’s tongue, I used to hold before
my mouth and nose a pocket-handkerchief moistened with vinegar[33].

Amid so great a number of deaths, I think there were only three persons of family, a few of the

principal citizens, and not more than three hundred foreigners of the common class, who fell victims to the
plague; the rest consisted of the lowest order of the Russian inhabitants. The former only purchased what
was absolutely necessary for their support, during the time of the pestilence; whereas the latter bought up
every thing which was rescued from the flames, and which of course was sold at a very low price; they
refused to burn the goods which came to them by inheritance; and, moreover, carried away many things

[29]

[30]

[31]

[32]

[33]

[34]

[35]

[36]

clandestinely, in spite of all we could say or do to the contrary.

Two surgeons died of the plague in the town; and a great number of surgeons-mates and pupils in the

hospitals. Dr. Pogaretzky and Mr. Samoïlowitz, first surgeon to the hospital of St. Nicholas, both caught
the infection several times; and were cured by critical sweats coming on at the beginning of each attack of
the disorder.

The foundling hospital, which contained about a thousand children[34] and four hundred adults

(including nurses, servants, masters, and workmen) was kept free from infection by the precautions
hereafter mentioned[35]. Only four workmen, and as many soldiers, who had got over the fences in the
night time, were seized at different times; but by immediately separating them from the rest of the house,
the disorder was prevented from spreading any farther. Thus this building was kept free from the plague, at
the time that it raged in all the other houses around it; a proof that the atmosphere, not only during the frost,
but even during the great heat of the summer[36], did not serve as a vehicle for spreading the contagion,
which was only propagated by contact of the sick or infected goods[37].

The young and robust were more liable to become infected than elderly and infirm persons; pregnant

women and nurses were not secure from its attacks. Children under four years of age were much less
readily infected, but when they were, they exhibited the worst symptoms.

All who were attacked with the plague had more or less fever; though in some it was so slight as to be

scarcely perceivable. In a few instances, the patients were seized, from the first, with a furious delirium,
accompanied with a high degree of fever; but the greater part were affected with debility, and only
complained of oppression about the præcordia, and head-ach[38].

After taking great pains to ascertain in what manner the plague was introduced into the military

hospital, the physician to that institution at length found out that two soldiers had died there in the month of
November, 1770, a short time after their arrival from Choczim, where the plague was then raging; and that
a Colonel, in whose train they were, had died upon the road. It would seem that the anatomical dissector
opened the bodies of these soldiers; and that he caught the plague of them. The persons who waited upon
the sick, either became infected by touching the bodies of these soldiers whilst they were living; or by
handling their clothes, or their bodies after death. These attendants afterwards spread the contagion among
their families.

Thus have we traced the history of the plague which depopulated Moscow in the year 1771, from its

first appearance to its final extinction. A plain and faithful statement of facts, even at the risk of being
tedious, is what has been aimed at in this narrative; for let it be observed, that it is from simple details of the
origin and progress of the plague, as it appears in different places, and of the symptoms and other
circumstances with which it is accompanied, and not from the laboured dissertations that have been written
upon it by some voluminous authors, that we can hope to acquire an accurate knowledge of the nature of
this disorder, to ascertain the manner in which its contagion is propagated, and lastly to discover the best
methods of prevention and cure.

A D D E N D A .

A.

Symptoms more particularly described.

The symptoms of the plague vary according to the different constitutions of the persons whom it

attacks, and the season of the year in which it appears. Sometimes it wears the mask of other diseases; but
in general it is ushered in by head-ach, stupor, resembling intoxication, shiverings, depression of spirits, and
loss of strength; these are followed by some degree of fever, together with nausea and vomiting. The eyes
become red, the countenance melancholy, and the tongue white and foul. In this state of things, the patients
are sometimes capable of sitting up, and going about for some hours, or even a day or two. They feel an
itching or pain in those parts of the body where buboes and carbuncles are about to appear. During the
height of the plague, many of the infected die on the second or third day, before these tumours have time to
come out, and with no other external marks except petechiæ or purple spots, which appear a short time
before death; in some these spots are altogether wanting. The buboes and carbuncles generally come out
on the second or third day, seldom on the fourth.

In some instances, the plague appears under the form of an inflammatory disorder, being accompanied

with great heat, thirst, high-coloured urine, flushed cheeks, and violent delirium or phrensy; but in the
greater number of cases it assumes the type of a nervous fever, being accompanied with little heat and
thirst, and pale and turbid urine; the patients think themselves only slightly indisposed, until a sudden
prostration of strength, and the eruption of buboes, carbuncles, petechiæ or vibices, announce to
themselves, as well as to those who are about them, the danger they are in. In some few instances, the

[37]

[38]

[39]

[40]

[41]

[42]

[43]

[44]

plague appears under the form of an intermittent fever.—Almost all those who are carried off by this
disorder, die before the sixth day; those who get over the seventh day have a good chance of recovery[39].

The diversity of symptoms above-noticed, has given rise to the opinion that there are three different

species of the plague, viz. one which is accompanied with petechiæ, another with carbuncles, and a third
with buboes; but the history which we have given, clearly proves, that these are only shades or
modifications of one and the same disorder, which is more or less violent under different circumstances and
at different seasons. Petechiæ, buboes, and carbuncles often appear at the same time in the same patient,
or occur in succession. In the month of July, great numbers of the impested died before the tumours came
out, having petechiæ only; whereas in August and September, almost every patient had petechiæ, joined
with buboes and carbuncles. After the middle of October, when the contagion was less virulent, although it
still produced petechiæ and carbuncles, yet they were neither so malignant nor so frequent. Before this
period, scarcely four patients in a hundred recovered; whereas during the latter months of the year, the
proportion of recoveries was much greater. Sydenham has made the same observation respecting the
plague at London[40]. Nature endeavours to throw off the poison by buboes. Carbuncles and petechiæ are
not critical eruptions; they only denote a putrid condition of the humours, and a great degree of acrimony;
whence it follows, that in proportion as buboes are more common, and petechiæ and carbuncles more
rare, the milder the plague is[41].

To this account which Dr. Mertens has given of the symptoms which the plague at Moscow exhibited,

we shall add the descriptions drawn up by two other practitioners (Orræus and Samoïlowitz,) who had
great opportunities of observation, and who have been more particular in noticing some of the phenomena
than our author.

According to Orræus (Descriptio Pestis, &c.) the plague in Russia appeared under four different

forms or varieties. Of these, he terms the first, the period of infection; the second, the slow type; the
third, the acute type; and the fourth, the exceedingly acute type.

1. In the period of infection (which is commonly the forerunner of the other forms of the plague) the

contagion, less active and virulent, keeps lurking in the body, and produces the following symptoms, viz.
sharp, flying pains in the glandular parts (such as the armpit and groins) and in the muscles of the neck and
breast; ardor urinæ; drowsiness; an increased secretion of the sebaceous humour, so that the skin is in
many parts, and more especially in the hands and face, much more unctuous and glossy than usual; the
belly is costive, but when moved, there comes away a great quantity of pulpy slimy fæces; the patients
complain of a heaviness of the body (some compare their limbs to a mass of lead), great lassitude and
faintings. A swelling, but without much pain, of some gland (in the groin or armpit) together with dark-red
or brown spots, denote a higher degree of infection: and a bad taste in the mouth, a viscidity of the saliva,
loss of appetite, whiteness and foulness of the tongue, and head-ach, show that the patient is going to be
attacked with the plague under one or other of the following types. The above-mentioned symptoms,
which continue for a longer or shorter time (in some instances for several days or even weeks) are not
accompanied with fever.

2. After the period of infection above described has continued for some time without yielding to

medicine, it generally ends in the slow type of the plague, which is characterized by the following
symptoms; viz. shiverings, followed by a moderate degree of heat[42], a febrile[43], unequal, for the most
part weak, and often intermitting pulse; a constant dull pain in the head (rather, according to the expression
of some patients, a heaviness, as if the head was full of lead); urine pale and turbid, but without sediment;
tongue foul and moist; very little thirst; depression of spirits; belly costive during the first three or four days,
with inflation of the hypochondria and borborygmi, but the abdomen feels soft on pressure; there is
frequent nausea and vomiting of a slimy greenish-yellow faburra[44]; petechiæ and other eruptions[45] make
their appearance, in some sooner in others later; but in some they are altogether wanting. The rudiments or
germs of buboes and carbuncles, which were forming during the period of infection, now gradually
increase in size, but without being accompanied with violent pain; and new ones arise in other places;
which, if they suppurate on the fifth, sixth, or seventh day, save the life of the patient: on the other hand, if
no suppuration takes place, and great debility, diarrhœa, and delirium come on, the disease terminates
fatally, not, however, in some cases till after the fourteenth day.

3. In the acute type, the plague is preceded by a much shorter indisposition, sometimes by none at all,

suddenly seizing persons in health. It is characterized by the following symptoms: a bitter taste in the mouth,
and a viscidity of the saliva; violent head-ach[46]; redness of the eyes[47] and face; a very foul, and
sometimes dry tongue; chilliness succeeded by considerable heat; a much fuller, stronger, and quicker
pulse than in the slow type of the disorder, as well as more thirst, and deeper coloured urine; costiveness;
buboes, and carbuncles come out soon after the attack of fever, or at the same time with it; after these,
others come out; frequent vomitings supervene, and a delirium, which is generally of the low kind[48]. If,

[45]

[46]

[47]

[48]

[65]

[66]

[67]

[68]

between the first and fourth day of the attack, the buboes are resolved[49], or they, as well as the
carbuncles, come to suppuration, the patient recovers: on the other hand, if no suppuration takes place
within that period; if the buboes and carbuncles increase to a great size, and the delirium continues, then
the powers of life become exhausted, the pulse sinks, and death is ushered in by hæmorrhages, and a
copious exspuition of thin phlegm[50]. Death takes place on the third, fourth, or fifth day; and it often
happens, while the corpse is yet warm, that petechiæ and other spots come out. The bodies, after death,
appear remarkably pale, soft, somewhat tumid, flexible, and free from fætor.

4. The plague, in its most acute type, attacks in various ways; but in relation to the leading symptoms,

it may be reduced to two forms: in the first, a person in perfect health, without any previous marks of
infection, is suddenly seized with a short but violent shivering fit, followed by a hot fit, which alternate with
each other sev...